Sentinel Node Mapping in Early Stage Endometrial Cancer: A Pilot Study, OMAR Z. YOUSSEF, AMR SELIM, AHMED TOUNY, IHAB KHALIL and HEBATOLLAH M. SHAABAN
Abstract
Introduction: We assessed the feasibility of sentinel node (SN) procedure based on the injection of patent blue dye in patients with endometrial cancer.
Methods: Twenty patients were included in this study. The median age of patients was 58 years (range 49-67 years). The median body mass index was 33.3 (range 28.1-38.8) and the mean was 31.5. All patient were diagnosed with histolog-ically proved endometrial cancer of stage I. They all underwent sentinel lymph node (SLN) biopsy procedure based on patent blue injected in the fundal subserous myometrium. After the SN procedure, all patients underwent complete pelvic lym-phadenectomy and either.
Results: In 17 cases blue colored lymph nodes were observed, while it wasn't identified in 3 patients. The detection rate for the SLN was 85%. Twenty-five SLN were detected in 17 cases, i.e. the mean number of SLN is 1.47 per case (range 1-3 lymph nodes). Three of the seventeen patients with colored SLNs showed metastasis; 2 cases in the obturator group of lymph nodes and 1 in the internal iliac lymph node group. Two out of these patients had other pelvic lymph nodes positive for metastasis, while the other patient had the SLN the only positive lymph node for metastasis.
Conclusions: SLN procedure based on injection of patent blue is feasible in patients with early endometrial cancer. It is a safe procedure, with minimal complications that may reduce the associated morbidity with the classical pelvic lymphadenectomy in selected cases of low grade early stage endometrial cancer. Further studies with larger number of patients should be done to standardize such procedure.